Carbohydrates and insulin resistance in clinical nutrition: Recommendations from the ESPEN expert group.

Details

Serval ID
serval:BIB_CA0F054B95AB
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Carbohydrates and insulin resistance in clinical nutrition: Recommendations from the ESPEN expert group.
Journal
Clinical nutrition
Author(s)
Barazzoni R., Deutz NEP, Biolo G., Bischoff S., Boirie Y., Cederholm T., Cuerda C., Delzenne N., Leon Sanz M., Ljungqvist O., Muscaritoli M., Pichard C., Preiser J.C., Sbraccia P., Singer P., Tappy L., Thorens B., Van Gossum A., Vettor R., Calder P.C.
ISSN
1532-1983 (Electronic)
ISSN-L
0261-5614
Publication state
Published
Issued date
04/2017
Peer-reviewed
Oui
Volume
36
Number
2
Pages
355-363
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Growing evidence underscores the important role of glycemic control in health and recovery from illness. Carbohydrate ingestion in the diet or administration in nutritional support is mandatory, but carbohydrate intake can adversely affect major body organs and tissues if resulting plasma glucose becomes too high, too low, or highly variable. Plasma glucose control is especially important for patients with conditions such as diabetes or metabolic stress resulting from critical illness or surgery. These patients are particularly in need of glycemic management to help lessen glycemic variability and its negative health consequences when nutritional support is administered. Here we report on recent findings and emerging trends in the field based on an ESPEN workshop held in Venice, Italy, 8-9 November 2015. Evidence was discussed on pathophysiology, clinical impact, and nutritional recommendations for carbohydrate utilization and management in nutritional support. The main conclusions were: a) excess glucose and fructose availability may exacerbate metabolic complications in skeletal muscle, adipose tissue, and liver and can result in negative clinical impact; b) low-glycemic index and high-fiber diets, including specialty products for nutritional support, may provide metabolic and clinical benefits in individuals with obesity, insulin resistance, and diabetes; c) in acute conditions such as surgery and critical illness, insulin resistance and elevated circulating glucose levels have a negative impact on patient outcomes and should be prevented through nutritional and/or pharmacological intervention. In such acute settings, efforts should be implemented towards defining optimal plasma glucose targets, avoiding excessive plasma glucose variability, and optimizing glucose control relative to nutritional support.

Keywords
Blood Glucose/metabolism, Carbohydrate Metabolism, Diet, Dietary Carbohydrates/administration & dosage, Dietary Carbohydrates/adverse effects, Evidence-Based Medicine, Glycemic Index, Humans, Hyperglycemia/etiology, Hyperglycemia/therapy, Hypoglycemia/etiology, Hypoglycemia/therapy, Insulin Resistance, Italy, Nutrition Policy, Nutritional Requirements, Nutritional Support, Risk Factors, Societies, Scientific, Carbohydrates, Clinical nutrition, Insulin resistance
Pubmed
Web of science
Create date
11/10/2016 17:16
Last modification date
20/08/2019 15:45
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